How are hospital CIOs shaping IT priorities in the era of meaningful use and ARRA?
In this podcast, Allana L. Cummings, VP and CIO of Children's Hospital & Medical Center in Omaha, Neb., shares her perspective with Hospitals and Health Networks Executive Editor Alden Solovy.
This interview is part of a podcast series developed by H&HN and Eclipsys.
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Podcast transcript:
Alden Solovy: How is your strategic plan addressing and preparing for the meaningful use requirements?
Allana Cummings: Our strategic plan since 2005 has really had the concept of meaningful use at mind. We had laid out a strategy to basically allow our physicians, administration and other users in our organization to be able to achieve benefit from their use of the electronic medical record system. So, in the idea of creating meaningful value, we think our strategy has pretty much stayed the same in that we’ve been trying to achieve value when users put data into the system, they’re also able to get information out of the system.
Solovy: So, it sounds like you’ve had it operationalized to some degree and a sense of what meaningful use might mean. How is your organization defining meaningful use at this point?
Cummings: Well, I think we’re certainly looking to the HIT Standards Committee and their meaningful use grid for what we’ll be evaluated against. However, for us, we’ve really been defining meaningful use based upon our ability to provide clinicians with data that answers questions or helps them address opportunities to improve patient safety in our organization.
Solovy: Does quality reporting come in there?
Cummings: It does. I think for us, our idea was that as we begin inputting data into our electronic medical record systems, we’ve already been planning for what are some of the key opportunities to look at our clinical care in terms of quality compared to our peers and where we as an organization see opportunities to perhaps compare practice amongst physicians, or even comparison on patient care units, and then finding those best practices and applying those and being able to check the quality of our outcomes and actually see improvements in a variety of areas throughout the organization.
Solovy: Can you give me an example of an area where you’ve seen those improvements?
Cummings: We’ve seen them from everything as simple as looking at our infections from central lines and looking at what best practices drive the best outcomes in our various patient care units. We’ve also looked at our meds administration processes and been able to, as a result of adding technology enhancements, such as an integrated medication management system in addition to our clinical documentation, seeing those systems share information, where what our pharmacists see and what our clinicians see is all the same clinical decision supports. And alert has really helped improve patient safety by driving down our number of medication errors.
Solovy: Are there particular challenges that are unique to children’s hospitals when it comes to thinking about meaningful use?
Cummings: I think one of the key challenges is that many of the standards that we’ll be measured against are very adult centric and probably less of a focus on some of the opportunities to really demonstrate improvements in care from a pediatric standpoint. And there’s certainly discussion going on amongst the various pediatric groups, such as CHCA and NACHRI that really are trying to bring to the forefront some additional indicators of quality amongst pediatric organizations. But, I think the planning is still the same, and that is you need an electronic medical record system that really supports providing clinical decision support to your clinicians and allowing them to go about their workflow in the most efficient and effective way possible. Again, we don’t wanna interrupt care for purpose of using an electronic medical record system. We really wanna use it to enhance the efficiency, and most importantly, be able to measure our outcomes.
Solovy: Is there an opportunity as other children’s hospitals come up to speed on the electronic medical record to create perhaps some new data that will improve clinical practice in the long run?
Cummings: I think we’re all hoping for that. I think the idea of having standardized data being collected, having key measurements that we’re all looking at our outcomes data and then sharing that across the pediatric community, I think, will drive further improvements in our safety of care.
Solovy: So, have there been unexpected roadblocks along the way in executing this drive toward meaningful use and executing your strategy?
Cummings: Not really. I think, again, in our organization’s situation, we have had a very deliberate path that we’ve been marching down to attain that. You know, certainly the economy did have some implications in slowing down some of our capital spending, so we’ve seen just an expanding of our timelines slightly based upon some capital requirements. But, other than that, I think for our organization and because of the particular path that we took, there haven’t been any unexpected roadblocks, other than just an extension of our timeline.
Solovy: What are your top three challenges, then, going forward, both with meaningful use and generally with IT in the organization?
Cummings: I think key things for us are going to continue to be cost management. In the situation of our current economy, you know, certainly proving cost benefit value of any of our IT investments is key, and that includes our EMR investment. Another key challenge for us will be continuing to look for optimization efforts while we’re finishing out our EMR deployment. It’s always a challenge to keep your focus on completing the technology roadmap for an EMR, but at the same time, taking advantage of the tools and improvements in workflow and continuing to tweak and enhance those to add to your user satisfaction. So, for us, it’s kind of the difficulty of balancing those two very important tasks, and we really rely heavily upon our clinical community to help us in that prioritization effort.
Solovy: Do you have any advice for hospitals that are just beginning this journey? And let me break that into both hospitals in general and children’s hospitals in specific.
Cummings: Sure. I think the key thing is really working with the organization in terms of your clinical leadership, your executive leadership in developing a strategy that is going to help you internally attain your own version of meaningful use, and then looking to see where that would coincide with the guidelines that are currently being offered. I don’t think organizations should significantly change their strategy just to go after the ARRA funding dollars. Instead, I believe that you should be looking first internally at meeting your own roadmap of needs, and then where possible, tweaking that to make sure that you do meet the timelines for optimal funding.
Solovy: And for children’s hospitals?
Cummings: I think it’s very similar. In our children’s hospital community, in particular, those that are freestanding pediatric organizations, most of us are fairly down a roadmap already of that deployment, and I think the continued openness of sharing successes and lessons learned is just something that we have to continue to do amongst the pediatric community.
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This podcast with Allana Cummings, VP and CIO of Children's Hospital & Medical Center in Omaha, Neb., is part of a series of interviews with hospital CIOs about IT strategy and preparing for meaningful use, conducted by H&HN Executive Editor Alden Solovy, and featured exclusively on www.whatismeaningful.com.
